Anticholinergics: theoretical and clinical overview
Prasad S Nishtala1, Mohammed Saji Salahudeen1, Sarah N Hilmer2
1a School of Pharmacy , University of Otago , Dunedin , New Zealand.
Expert Opinion on Drug Safety
|March 12, 2016
Summary
Anticholinergic medicines, common in older adults, can cause cognitive and functional issues. Minimizing anticholinergic burden by adjusting or stopping these medications is crucial for better health outcomes in the elderly.
Area of Science:
- Gerontology
- Pharmacology
- Neuroscience
Background:
- Anticholinergics block acetylcholine, impacting brain and peripheral tissues.
- These medications are frequently prescribed to older adults for various conditions.
- A significant proportion of commonly prescribed drugs possess anticholinergic activity.
Purpose of the Study:
- To review the pharmacology, epidemiology, and clinical impact of anticholinergic activity in older adults.
- To discuss measures and effects of cumulative anticholinergic burden.
- To identify research gaps and provide clinical recommendations.
Main Methods:
- Review of theoretical and clinical aspects of anticholinergic medicines.
- Examination of pharmacology, including antimuscarinic receptors and effects.
- Analysis of epidemiological data and measures of anticholinergic burden.
Main Results:
- Anticholinergic burden is a recognized predictor of cognitive and functional impairments in the elderly.
- Cumulative exposure to anticholinergic drugs contributes to adverse health outcomes.
- Various methods exist to quantify anticholinergic burden, considering number, dose, and activity level.
Conclusions:
- Many widely used medications in older adults have anticholinergic properties.
- Anticholinergic burden negatively impacts health and function in older populations.
- Minimizing anticholinergic burden through avoidance, dose reduction, or deprescribing is recommended.
Keywords:
Anticholinergicacetylcholineanticholinergic activityanticholinergic adverse effectanticholinergic burdenanticholinergic mechanismanticholinergic medicineanticholinergic overviewanticholinergic risk scaleantimuscarinicmuscarinic receptorolder peopleMore Related Videos
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